Healthcare Provider Details

I. General information

NPI: 1306062112
Provider Name (Legal Business Name): COMFORT DENTAL WESTMINSTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 09/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10350 NORTH FEDERAL BLVD STE 300
FEDERAL HEIGHTS CO
80260
US

IV. Provider business mailing address

10350 NORTH FEDERAL BLVD STE 300
WESTMINSTER CO
80260
US

V. Phone/Fax

Practice location:
  • Phone: 303-427-2722
  • Fax: 303-427-9280
Mailing address:
  • Phone: 303-427-2722
  • Fax: 303-427-9280

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number9964
License Number StateCO

VIII. Authorized Official

Name: DR. CORY HIGGINBOTHAM
Title or Position: GENERAL DENTIST
Credential: DDS
Phone: 303-427-2722